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I Am Still Trying To Help My 59-yr-old Male Friend

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Posted on Tue, 11 Feb 2020
Question: I am still trying to help my 59-yr-old male friend get a solution to his problem of getting phlegm in his throat and feeling the need to spit, sometimes every 40 seconds in episodes that can last 30 min or more. He does have periods of time without spitting, but he is controlling this spitting behavior less and less.
He has been to 5 ERs in the last 3 weeks. We finally saw his general doctor yesterday. She read the reports from his visits to the ERs. I have also seen some of the X-rays, but not the MRI's. The written reports seem to show nothing "wrong" with X-rays of his lungs or NMR images of his neck and head.
Yet my friend still has his problem. We are now considering that his problem might be psychological. But if that is so, can a psych problem cause the excessive behavior of bringing up phlegm and feeling the need to spit it out? From what I observe, he spits up 2-3 mls of clear bubbly or yellowish phlegmy substance about every 5th spit or so.
Should we collect and analyze his spit? Guidance and suggestions wanted. Thanks.
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Follow up: Dr. Dr. Jolanda (0 minute later)
I am still trying to help my 59-yr-old male friend get a solution to his problem of getting phlegm in his throat and feeling the need to spit, sometimes every 40 seconds in episodes that can last 30 min or more. He does have periods of time without spitting, but he is controlling this spitting behavior less and less.
He has been to 5 ERs in the last 3 weeks. We finally saw his general doctor yesterday. She read the reports from his visits to the ERs. I have also seen some of the X-rays, but not the MRI's. The written reports seem to show nothing "wrong" with X-rays of his lungs or NMR images of his neck and head.
Yet my friend still has his problem. We are now considering that his problem might be psychological. But if that is so, can a psych problem cause the excessive behavior of bringing up phlegm and feeling the need to spit it out? From what I observe, he spits up 2-3 mls of clear bubbly or yellowish phlegmy substance about every 5th spit or so.
Should we collect and analyze his spit? Guidance and suggestions wanted. Thanks.
doctor
Answered by Dr. Dr. Jolanda (1 hour later)
Brief Answer:
He should exclude allergies and gastric reflux first

Detailed Answer:
Hello and welcome in Ask the Doctor

I can understand your concern

According to the history of his symptoms you prescribe, I would recommend you to do the following:

1. A specialist of allergy should see him to exclude several allergies because they might be a cause.
2. A gastroscopy examination is needed to exclude gastric reflux if no allergies are found.

If no findings from the above then it is a psychiatrist that he should see for the exact diagnosis and treatment.

Please discuss with his doctor for the above

Regards

Dr.Jolanda
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Dr. Jolanda (0 minute later)
Brief Answer:
He should exclude allergies and gastric reflux first

Detailed Answer:
Hello and welcome in Ask the Doctor

I can understand your concern

According to the history of his symptoms you prescribe, I would recommend you to do the following:

1. A specialist of allergy should see him to exclude several allergies because they might be a cause.
2. A gastroscopy examination is needed to exclude gastric reflux if no allergies are found.

If no findings from the above then it is a psychiatrist that he should see for the exact diagnosis and treatment.

Please discuss with his doctor for the above

Regards

Dr.Jolanda
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Dr. Jolanda (20 hours later)
Brief Answer:
Continue discussion

Detailed Answer:
Hi again
You are welcome

Regards

Dr.Jolanda
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Dr. Jolanda (0 minute later)
Brief Answer:
Continue discussion

Detailed Answer:
Hi again
You are welcome

Regards

Dr.Jolanda
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Jolanda (26 minutes later)
Thank you, Dr. Jnikola. I will bring your answer to my friend and the people in charge of the home where he lives.
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Follow up: Dr. Dr. Jolanda (0 minute later)
Thank you, Dr. Jnikola. I will bring your answer to my friend and the people in charge of the home where he lives.
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Follow up: Dr. Dr. Jolanda (4 days later)
Dear Dr. Jnikolla,

I did type a letter to his doctor's office and delivered it to her office after hours on Friday. I did go back to that office on Monday to find out that he had been taken by his caseworker to have his blood drawn for a blood test. I THOUGHT that it was because I had left the letter.
NOW my friend is hiccupping constantly, about every 15 seconds. He has been doing that for about 4 days. He has not been eating. He asked me for Milk of Magnesia and I brought him some just tonight. He is truly sick with his hiccupping and spitting. When I was with him a couple days ago, he spit onto the pavement at his feet while we were sitting outside on a bench. The puddle he made in several minutes was clear mucus and about 6 inches in diameter. I can send photos or videos of it.
I really don't know what to do. I will go back to the place where he is staying on Tuesday and talk with the person in charge.
Sorry about asking for help, but I really don't know what to do. I will talk to the head person about your answer, which I submitted to the person in charge, as well as to the doctor, and to my friend.
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Follow up: Dr. Dr. Jolanda (0 minute later)
Dear Dr. Jnikolla,

I did type a letter to his doctor's office and delivered it to her office after hours on Friday. I did go back to that office on Monday to find out that he had been taken by his caseworker to have his blood drawn for a blood test. I THOUGHT that it was because I had left the letter.
NOW my friend is hiccupping constantly, about every 15 seconds. He has been doing that for about 4 days. He has not been eating. He asked me for Milk of Magnesia and I brought him some just tonight. He is truly sick with his hiccupping and spitting. When I was with him a couple days ago, he spit onto the pavement at his feet while we were sitting outside on a bench. The puddle he made in several minutes was clear mucus and about 6 inches in diameter. I can send photos or videos of it.
I really don't know what to do. I will go back to the place where he is staying on Tuesday and talk with the person in charge.
Sorry about asking for help, but I really don't know what to do. I will talk to the head person about your answer, which I submitted to the person in charge, as well as to the doctor, and to my friend.
doctor
Answered by Dr. Dr. Jolanda (3 hours later)
Brief Answer:
Please send him to the emergency

Detailed Answer:
Hi again

I am sorry for your friend situation

Given the fact that you say he is not good I strongly recommend you to send him to ER. They will examine him closely and will do the labs there and he will also get help.

Please send him to the emergency

Regards

Dr.Jolanda
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Dr. Jolanda (0 minute later)
Brief Answer:
Please send him to the emergency

Detailed Answer:
Hi again

I am sorry for your friend situation

Given the fact that you say he is not good I strongly recommend you to send him to ER. They will examine him closely and will do the labs there and he will also get help.

Please send him to the emergency

Regards

Dr.Jolanda
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Dr. Jolanda (11 hours later)
Brief Answer:
Continue discussion

Detailed Answer:
Hi again

Send him to emergency to be evaluated further.

Hope his problem to be solved

Regards

Dr.Jolanda
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Dr. Jolanda (0 minute later)
Brief Answer:
Continue discussion

Detailed Answer:
Hi again

Send him to emergency to be evaluated further.

Hope his problem to be solved

Regards

Dr.Jolanda
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Jolanda (27 minutes later)
Thank you. He called me this morning and asked for help. He is hiccupping constantly, even while he tries to talk. I promised to go to him. I will tell you what happens later.
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Follow up: Dr. Dr. Jolanda (0 minute later)
Thank you. He called me this morning and asked for help. He is hiccupping constantly, even while he tries to talk. I promised to go to him. I will tell you what happens later.
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Follow up: Dr. Dr. Jolanda (7 hours later)
Hi Dr. Jolanda,

Today we went to urgent care. My friend is discouraged. He was not very patient or cooperative, but the urgent care nurse said that she had COPD and keeps it in check. She said that my friend's ears are full. She also looked up his nose. She wanted to know which meds he is taking. I will have to insist on learning from his facility tomorrow, because I could not tell her and my friend does not know the answer.
This nurse prescribed Flonase and Singulair tablet presecription. (10 mg).
I liked her and thought that it would be good for us to try. She said that I could call her back in a week.

While we were in the waiting room, my friend lay on his back and hiccupped. When he is standing he brings up phlegm and spits. He has not eaten for two days. He is concerned, because all he does is spit it up. I hope he lasts through the night. I will talk to the head of the facility tomorrow and hopefully go get his prescriptions.
Is there anyone else who can give me additional guidance in addition to what you have said? I have never met anyone who brings up phlegm and spits like my friend does. His phlegm is white in color with some bubbliness.
Thank you to all who help.
default
Follow up: Dr. Dr. Jolanda (0 minute later)
Hi Dr. Jolanda,

Today we went to urgent care. My friend is discouraged. He was not very patient or cooperative, but the urgent care nurse said that she had COPD and keeps it in check. She said that my friend's ears are full. She also looked up his nose. She wanted to know which meds he is taking. I will have to insist on learning from his facility tomorrow, because I could not tell her and my friend does not know the answer.
This nurse prescribed Flonase and Singulair tablet presecription. (10 mg).
I liked her and thought that it would be good for us to try. She said that I could call her back in a week.

While we were in the waiting room, my friend lay on his back and hiccupped. When he is standing he brings up phlegm and spits. He has not eaten for two days. He is concerned, because all he does is spit it up. I hope he lasts through the night. I will talk to the head of the facility tomorrow and hopefully go get his prescriptions.
Is there anyone else who can give me additional guidance in addition to what you have said? I have never met anyone who brings up phlegm and spits like my friend does. His phlegm is white in color with some bubbliness.
Thank you to all who help.
doctor
Answered by Dr. Dr. Jolanda (7 hours later)
Brief Answer:
Continue discussion

Detailed Answer:
Hi again

I am happy you have found a solution.
No for the moment just follow her prescription and see how it will work.

I am sure he will get better after taking it.

Regards

Dr.Jolanda

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Dr. Jolanda (0 minute later)
Brief Answer:
Continue discussion

Detailed Answer:
Hi again

I am happy you have found a solution.
No for the moment just follow her prescription and see how it will work.

I am sure he will get better after taking it.

Regards

Dr.Jolanda

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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I Am Still Trying To Help My 59-yr-old Male Friend

I am still trying to help my 59-yr-old male friend get a solution to his problem of getting phlegm in his throat and feeling the need to spit, sometimes every 40 seconds in episodes that can last 30 min or more. He does have periods of time without spitting, but he is controlling this spitting behavior less and less. He has been to 5 ERs in the last 3 weeks. We finally saw his general doctor yesterday. She read the reports from his visits to the ERs. I have also seen some of the X-rays, but not the MRI's. The written reports seem to show nothing "wrong" with X-rays of his lungs or NMR images of his neck and head. Yet my friend still has his problem. We are now considering that his problem might be psychological. But if that is so, can a psych problem cause the excessive behavior of bringing up phlegm and feeling the need to spit it out? From what I observe, he spits up 2-3 mls of clear bubbly or yellowish phlegmy substance about every 5th spit or so. Should we collect and analyze his spit? Guidance and suggestions wanted. Thanks.